The impact of circulating cholesterol crystals on vasomotor function: implications for no-reflow phenomenon.

Objectives: The purpose of this study was to determine if cholesterol crystals can injure the endothelial surface by their jagged edges altering vasoreactivity and contributing to no-reflow after intervention.

Background: After plaque rupture, cholesterol crystals are released into the circulation and flow downstream contacting the arterial wall.

Methods: Both carotid arteries from 22 rabbits were placed in a dual perfusion chamber and challenged with norepinephrine followed by acetylcholine and nitroprusside.

Inappropriate Implantable Cardioverter-Defibrillator Therapy.

Although improvements in implantable cardioverter-defibrillator (ICD) therapy have taken place, many challenges do remain. Inappropriate delivery of therapy is a big problem that impacts the quality of life of ICD recipients. Although there is now a clear understanding that atrial arrhythmias are the main cause of inappropriate ICD therapies, physicians have not been very successful in preventing them.

Randomized evaluation of right atrial ablation after left atrial ablation of complex fractionated atrial electrograms for long-lasting persistent atrial fibrillation.

Background: With electrogram-guided radiofrequency ablation (RFA) of long-lasting persistent atrial fibrillation (AF), the best results have been reported when complex fractionated electrograms (CFAEs) in both the left (LA) and right (RA) atria were targeted. However, many studies have reported excellent outcomes from RFA of long-lasting persistent AF with the use of other ablation strategies that were limited to the LA. The incremental value of RFA of RA CFAEs is yet to be defined.

Inducibility of paroxysmal atrial fibrillation by isoproterenol and its relation to the mode of onset of atrial fibrillation.

Background: Isoproterenol has been used to assess inducibility during catheter ablation for paroxysmal PAF. However, no studies have determined the sensitivity and specificity of isoproterenol for the induction of AF. It also is not clear whether isoproterenol is equally effective in inducing AF in the clinical subtypes of vagotonic, adrenergic, and random AF.

Radiofrequency catheter ablation of chronic atrial fibrillation guided by complex electrograms.

Background: Radiofrequency catheter ablation of atrial fibrillation (AF) guided by complex fractionated atrial electrograms has been reported to eliminate AF in a large proportion of patients. However, only a small number of patients with chronic AF have been included in previous studies.

Methods And Results: In 100 patients (mean age, 57+/-11 years) with chronic AF, radiofrequency ablation was performed to target complex fractionated atrial electrograms at the pulmonary vein ostial and antral areas, various regions of the left atrium, and the coronary sinus until AF terminated or all identified complex fractionated atrial electrograms were eliminated.